EVALUATION OF SURGICAL OUTCOMES OF VIDEO-ENDOSCOPIC INGUINAL LYMPHADENECTOMY WITH GREAT SAPHENOUS VEIN PRESERVATION IN THE TREATMENT OF PENILE CANCER AT VIET DUC UNIVERSITY HOSPITAL
Main Article Content
Abstract
Objectives: To evaluate the safety, oncological efficacy, and complication-reducing capability of video endoscopic inguinal lymphadenectomy with great saphenous vein preservation in patients with penile squamous cell carcinoma.
Methods: A case series study was conducted on 38 patients who underwent video endoscopic inguinal lymphadenectomy with great saphenous vein preservation at Viet Duc University Hospital between March 2022 and March 2025. Evaluated parameters included perioperative outcomes, postoperative complications (graded by the Clavien-Dindo classification), disease-free survival, and inguinal recurrence-free survival. Survival analysis was performed using the Kaplan-Meier method and the log-rank test.
Results: The study cohort comprised 38 patients with a mean age of 52.9 ± 11.1 years. The mean overall operative time was 136.1 ± 35.1 minutes. The mean inguinal lymph node yield was 16.9 ± 5.6 nodes. The flap-preserving technique was associated with excellent surgical outcomes, achieving a 0% rate of both surgical site infection and skin flap necrosis. The overall complication rate was 18.4%, with a postoperative seroma rate of 7.9%. Over a median follow-up of 29.5 months, the 2-year disease-free survival and inguinal recurrence-free survival rates were 89% and 97%, respectively. Correlation analysis using a 12-node cutoff revealed no significant differences in disease-free survival (p = 0.362) and inguinal recurrence-free survival (p = 0.637) between patients with < 12 nodes and those with ≥ 12 nodes during the follow-up period.
Conclusions: Video endoscopic inguinal lymphadenectomy with great saphenous vein preservation is a safe, feasible, and oncologically highly effective procedure. This technique eliminates the risk of surgical site skin necrosis, significantly minimizes lower limb lymphedema, and ensures an optimal lymph node yield alongside durable local disease control.
Article Details
Keywords
Video endoscopic inguinal lymphadenectomy (VEIL), great saphenous vein, penile cancer.
References
[2] National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: penile cancer, version 1.2026. Plymouth Meeting, PA: National Comprehensive Cancer Network, 2026. Accessed March 4, 2026.
[3] Tobias-Machado M, Ornellas A.A, Hidaka A.K et al. Long-term surgical and oncological outcomes after video endoscopic inguinal lymphadenectomy (VEIL) in patients with penile cancer. Int Braz J Urol, 2023, 49 (5): 580-589. doi: 10.1590/S1677-5538.IBJU.2023.0065
[4] Alqudrah F, Passarelli R, Sykes J, Islam R, Chua K, Ghodoussipour S. Video-endoscopic inguinal lymphadenectomy (VEIL): oncological and surgical benefits compared to open inguinal lymph node dissection (ILND). J Mens Health, 2024, 20 (7): 20-25. doi: 10.22514/jomh.2024.106
[5] Salazar-Messias I.M, Sotelo R, Subirá-Ríos D et al. Techniques, outcomes, and complications of minimally invasive inguinal lymphadenectomy in cancer of the penis: an international clinical review. AME Med J, 2023, 8: 24. doi: 10.21037/amj-22-68
[6] Nguyễn Hữu Thảo, Nguyễn Quang, Trịnh Hoàng Giang, Nguyễn Tiến Dũng, Bùi Xuân Trường. Xử lý hạch trong điều trị ung thư dương vật: Tổng quan. Tạp chí Y học Cộng đồng, 2024, 65 (CĐ 4): 180-187. doi: 10.52163/yhc.v65iCD4.1173
[7] Andreșanu A, Gîngu C, Georgescu D.E et al. Prognostic factors of survival in patients with surgically treated penile squamous cell carcinoma: a retrospective cohort analysis. Cancers (Basel), 2026, 18 (6): 952. doi: 10.3390/cancers18060952
[8] Tan Y.G, Fong K.Y, Goh N.K et al. Comparing the perioperative and oncological outcomes of open versus minimally invasive inguinal lymphadenectomy in penile cancer: a systematic review and meta-analysis. Cancers (Basel), 2025, 17 (18): 3035. doi: 10.3390/cancers17183035
[9] Shao Y, Hu X, Ren S et al. Comparison of different surgical methods and strategies for inguinal lymph node dissection in patients with penile cancer. Sci Rep, 2022, 12 (1): 2560. doi: 10.1038/s41598-022-06494-z
[10] Gao Y, Shao Y, Li X et al. Risk factors of complications after inguinal lymph node dissection in patients with penile cancer. J Clin Oncol, 2025, 43 (5_suppl): 6. doi: 10.1200/JCO.2025.43.5_suppl.6
[11] Gómez-Ferrer A, Collado A, Ramírez M et al. A single-center comparison of initial experiences treating penile and urethral cancer with video endoscopic inguinal lymphadenectomy (VEIL), and its later application in melanoma patients. Front Surg, 2022, 9: 870857. doi: 10.3389/fsurg.2022.870857
[12] Li Z.S, Yao K, Chen P et al. Disease-specific survival after radical lymphadenectomy for penile cancer: prediction by lymph node count and density. Urol Oncol, 2014, 32 (6): 893-900. doi: 10.1016/j.urolonc.2013.11.008